health_care_financing_in_the_usfandomcom-20200213-history
Private Insurance Programs
Private Insurance – Brittany Powell (Vandenkieboom) Edited by Mirna Chaytou (Edits are underlined) Private health insurance is health insurance provided by the private health insurance industry as opposed to provided by government run programs. Examples of private health insurance include Blue Cross Blue Shield, Health Alliance Plan and UnitedHealthOne, to name a few. The majority of private health insurance is bought by employers as a benefit for employees (Schreck, 2018). The cost of this insurance is usually shared by the employer and the employee. However, the majority of the cost is covered by the employer. For example, employer sponsored health insurance premiums averaged $18,142 per year in 2016 and employees paid less than 1/3 of this cost from their paychecks (Norris, 2016). It is estimated that 47% of the population receives health insurance from employment based private insurance (Bodenheimer & Grumbach, 2016). Private insurance covers 155 million people throughout the country, including employees and their dependents (Norris, 2016). The benefits of this type of private health insurance include cost, east of enrollment, and variety of plan options (Norris, 2016). For those who do not have access to employer sponsored health insurance, people can also purchase private health insurance directly for themselves. This accounts for 7% of the population (Bodenheimer & Grumbach, 2016). However, this statistic was prior to the individual insurance mandate under the Affordable Care Act. There are advantages and disadvantages when choosing a private insurance company over a public one. Private health insurance facilities are usually less busy than a public facility. This means much shorter wait times for the patients in comparison to public facilities. Whether the visit is an emergency or an annual physical exam, treatment is provided as quickly as possible. Even when the patient encounters an instance where care may be delayed due to a longer wait, with private insurance there are always options to pay more for faster medical attention. Public health facilities are supported by the government and because of this funding is limited. The funds provided by the government may never be enough to meet the needs of every person. On the other hand private facilities are always well funded and well maintained. When experiencing care through private health insurance companies one can expect to find comforts such as TV's and refreshments. The down side to private insurance is that if not provided by an employer, they can get expensive quickly. This can make things difficult for some to find the private insurance company within their means (Neeman, 2018). Affordable Care Act – Brittany Powell (Vandenkieboom) The Affordable Care Act was enacted in 2014 to increase the availability, affordability and use of health insurance by the population (Schreck, 2018). Many aspects of the Affordable Care Act involve the private insurance market. This includes individual and employer mandates related to private health insurance. The Affordable Care Act requires that all U.S. citizens and legal residents have insurance coverage (Bodenheimer & Grumbach, 2016). Those who do not comply are subject to a tax penalty. The Affordable Care Act also included an employer mandate that requires employers with 50 or more employees to provide health insurance or pay a penalty (Bodenheimer & Grumbach, 2016). The Affordable Care Act also expanded Medicaid as well. It allowed for everyone below 133% of the poverty level to qualify for Medicaid (Bodenheimer & Grumbach, 2016). Some other changes under the Affordable Care Act included allowing coverage for dependents up to age 26 years old, reducing the prescription drug coverage gap under Medicare part D, and restricting insurance companies from denying coverage due to pre-existing conditions (Bodenheimer & Grumbach, 2016). The Affordable Care Act has resulted in lower rates of the uninsured, falling below 9% in 2016 (Norris, 2016).